CONCENTRATED DDAVP: FURTHER IMPROVEMENT FOR THE TREATMENT OF MILD F.VIII DEFICIENCIES

We have evaluated the pharmacological efficacy of a concentrated DDAVP preparation (40 μg/mL) (herein referred to as C-DDAVP) administered subcutaneously (s.c.) in mild (n=23) and moderate (n=2) hemophilia A patients. A comparison between the response to s.c. C-DDAVP and the "dilute" DDAVP (4 μg/ml) (administered s.c. in 16 patients with mild (n=13) and moderate (n=3) hemophilia A and i.v. in 18 patients with mild (n=16) and moderate (n=2) was also carried out. In all instances Desmopressin was given at a dose of 0.3 μg/kg b.w. in absence of bleeding. The increase of F. VIII:C (expressed as post/pre ratio) after s.c. C-DDAVP was 2,55 at 30', 3,50 at 60'and 3,21 at 120'. The comparison among the three schedules of DDAVP administration showed that s.c. C-DDAVP elicited an increase of F. VIII :C at least as high as that induced by the dilute DDAVP with differences not statistically significant.

C-DDAVP was also administered s.c. in 4 patients with type I vWD (platelet normal subtype) with a normalization of bleeding time 60' after s.c. C-DDAVP, concomitant with a rise of activities related to F. VIII/vWF complex. Side effects were modest and transient. We can conclude that s.c. C-DDAVP is equally effective and safe in comparison with the dilute brand with the advantage of the minimal adminstration volume (<1 mL).